SummaryA case of villous adenoma complicated by severe fluid and electrolyte depletion has been reported. Some unique features of the villous adenoma and the treatment of the electrolyte depletion syndrome have been discussed. Several points should be stressed in relation to this syndrome: (1) Villous adenomas are easily missed on digital examination because of their soft consistency. (2) The electrolyte depletion syndrome, though uncommon, can be severe, and several deaths are reported in medical literature. They resulted from failure of early or adequate treatment. (3) Malignant change occurs frequently and necessitates wide removal.